Tuning in…
Tuning in…
Castaway
1 appearance
Physician, oncologist, and Pulitzer Prize-winning author of 'The Emperor of All Maladies', known for his work on cancer genetics and stem cells.
On the island
Eight records
All of MeFavourite
It seems so much a metaphor for the body, for what doctors do, what patients go through.
I love the gritty rawness of the voice. It's like thunder in the middle of the night when you wake up and it's raining and there's thunder.
To contrast with Amir Khan's Thunder at Midnight, I also wanted to play something more lyrical from Indian classical music.
I was very late to the jazz party, which was unusual, because of course the connections between jazz and Indian classical music are so apparent now.
What you'll hear is this piece in which you hear this syncopated rhythm. And this rhythm is exciting, and I like the liveness of it.
inspired by this kind of cerebral, circular, meditative quality of Indian classical music... we are going to metamorphosize as a species.
I needed something a little bit more upbeat and optimistic and peppy, but also strong.
In conversation
Presenter asks
2:15Why is it useful to frame these stories in a much bigger picture of where medicine and science are now?
When I conceive of either the book on the gene or my previous book on cancer in Emperor, I started out by asking, what are we trying to answer here? Why am I interested in it? You know, this thing that envelops culture, that invades, metastasizing into our lives in ways that are so complicated and that we struggle to understand. But in the midst of all of this sort of whirr, there is a single human being in some clinic somewhere getting her head shaved because she is anticipating chemotherapy tomorrow, or deciding whether or not to take a drug that is experimental, or signing a consent form to sign up for a therapeutic trial. And her question, his question, is very simple. Where are we and how do we get here? Where are we going next? And then the stories become ways to answer that question.
Presenter asks
3:44What would you like patients to understand about cancer?
One important thing to keep at the front is that this disease I think is not going away. The idea that we will erase it from the face of human history, I think is a pipe dream. It is part of us, not only in a cultural way, but it's part of us in a biological way. There's a biological truth to the idea that the very genes that cause our wounds to heal and our embryos to grow, which give us the capacity to become multicellular organisms with all the beautiful things that come with it, are vulnerabilities and they're inescapable vulnerabilities. That's the important piece of it. We can't scratch them out of ourselves, of our souls, of our biological beings. And so the two helices, as it were, of cancer and humans are twisted around each other. And that's not to be nihilistic about the treatment of cancer, but it is to recognize that part of the complexity of treating cancer is that there are very few diseases where the fundamental of the disease is so locked in with the fundamental of who we are.
The keepsakes
The book
Complete Works of George Orwell
George Orwell
I find him refreshing to read. Sometimes he's a slap in your face, but there's a kind of clarity, a lucidity that comes with seeing the world for what it is and pointing out all its perversities, but also some of its beautiful things.
The luxury
a small, portable light microscope
Every morning really begins at the ritual for me. When I go to the lab, or even when I'm going to see patients, I look at biopsies. And if I was sitting in a desert island somewhere, I had nothing else to do, at least that'd be the whole sub-visual world. I could look at all the beetles and the things that were on the island and discover a whole new world with them.
Presenter asks
7:13What do you make of the language we use around cancer, like 'battling it' and 'beating it'? Does it annoy you?
It doesn't annoy me, you know. Patients, doctors, we, you, me, will have different conceptions of their illness. Some of them actually like battling. There was a time fifty odd years ago when there was a fatalism around cancer. No one was battling it because it was not talked about. And then there was a time 30 years later where everyone was battling it and fighting it because it was thought to be curable. So each of these moments, I think, comes with its own burdens. I think, thankfully, this is part of the abolition of this moment. Thankfully, we're slowly understanding that the biology dictates what happens to you. It isn't you, it's the cancer. And to a large extent, that's true.
Presenter asks
10:56Can you tell me a little bit more about your paternal grandmother?
She was a difficult but inspiring character. She had by then already lost one son who had succumbed to illness, but basically triggered by his bipolar disorder. And another son, so another uncle, was becoming floridly schizophrenic at that time. And so she came to live with us with her son, and they lived in the same room. And she's a powerfully austere person. She had seven articles of clothing which she would wash every day and wear only those. She cooked her own meals and she cooked the same meal every day. I mean, I write to think. And until I wrote about it, I didn't fully figure out what it really meant. But the conflict was between her as a protector of her schizophrenic son and my father, who was her favorite child. And so she turned against my father, who was, as I said, her favorite son, in a way that was like a tigress. But the idea of protecting the ill child obviously left a very deep impression on me, I think, and ultimately had an impact on how I chose to live my life.
Presenter asks
18:49At the point at which you know you're onto something game-changing, describe that moment.
Robert Sapolsky, who's a writer, described it once to me. He was actually a professor at Stanford. He described to me as if all of a sudden you get handed and you get to own a little slice of the universe. I like that idea very much, that you feel as if you've opened a trapdoor and discovered a piece of the natural world. It's an entirely addictive feeling. And like all kinds of addicts, we live for that high. I remember when I was working on Epstein-Barr virus at Oxford, I very clearly remember when I began to understand why this virus might escape the immune system. I remember the experiment that I did, I remember the night it was done, I remember coming in at night, reading the, you know, in those days we used to read, this was all done radioactively. These days we don't do radioactively, but you had to sit in front of the counter and it was excruciatingly slow because it would read one well by another well and there were 96 wells to be read. And you would sit by the counter and you had to watch it because of course it was glowing with radioactivity. And I remember sitting there and from the numbers I knew that the experiment had worked and then we repeated it several times. But I think I went home and went to sleep. There was no one to celebrate with.
Presenter asks
31:54How has your work affected your attitude to your own mortality?
I think it's it's uh simplified things for me. I was very intrigued and moved by two other books in recent times, Being Mortal by Atul Gawande, who I know has been on your on your show, and Paul Kalanithi's book, When Breath Becomes Air. They're telling us something about the human body and how ultimately we're programmed to die. And what that means, where where do we stop treating, where do we start thinking about the end, is a question that I think will occupy us for the next fifty odd years as we make new advances in cancer therapy in particular.
“this thing that envelops culture, that invades, metastasizing into our lives in ways that are so complicated and that we struggle to understand. But in the midst of all of this sort of whirr, there is a single human being in some clinic somewhere getting her head shaved because she is anticipating chemotherapy tomorrow...”
“This disease I think is not going away. The idea that we will erase it from the face of human history, I think is a pipe dream. It is part of us, not only in a cultural way, but it's part of us in a biological way.”
“She was a difficult but inspiring character. She had by then already lost one son who had succumbed to illness, but basically triggered by his bipolar disorder. And another son, so another uncle, was becoming floridly schizophrenic at that time. And so she came to live with us with her son, and they lived in the same room. And she's a powerfully austere person. She had seven articles of clothing which she would wash every day and wear only those. She cooked her own meals and she cooked the same meal every day.”
“Robert Sapolsky, who's a writer, described it once to me. He was actually a professor at Stanford. He described to me as if all of a sudden you get handed and you get to own a little slice of the universe. I like that idea very much, that you feel as if you've opened a trapdoor and discovered a piece of the natural world. It's an entirely addictive feeling. And like all kinds of addicts, we live for that high.”
“I love solitude. You know, one thing that music, or at least training musically makes you love, is silence. And you know, when I thought about putting this together, actually the thing that came to mind was not so much a desert island, but was a journey in space. These are the eight things that I would take with me to space.”